Software Helps Doctors Calculate Heart Attack Risk

An international consortium of researchers, led by the University of Edinburgh, has developed a programme that enables doctors to swiftly assess the severity of a patient's condition. The new 'risk calculator' is already being used in British hospitals.

Doctors using the new system take key data from patients at their bedside, and input it into the specially-devised programme. Key facts -- such as a patient's age, medical history and blood pressure -- are recorded by doctors, as well as information derived from on-the-spot blood samples and kidney tests.

The new patient's statistical profile is then input into a computer and matched with data derived from thousands of other coronary cases. Using the outcomes of these previous cases as a guide, the computer will not only give an accurate assessment of the new patient's conditions, but also recommend possible treatment. Significantly, it will be able to predict the likelihood the patient suffering a heart attack, and even their chances of dying in the next months.

Chest pain accounts for more than a quarter of all emergency medical admissions in the United Kingdom. Spotting high risk heart patients quickly can be difficult, but Professor Keith Fox, of the University of Edinburgh, says the new tool will help: "Identifying those with threatened heart attack from the very many patients with chest pain is a real clinical challenge, but critically important in guiding emergency and subsequent patient care. Higher risk patients need more intensive medical and interventional treatment."

An international group of cardiologists and statisticians have spent several years producing the Global Registry of Acute Coronary Events (GRACE) calculator. The complex statistical model has been developed using data derived from six-year study of more than 40,000 coronary patients worldwide.

Professor Fox adds: "The device has recently been introduced into hospitals, following an additional two-year trial on coronary patients admitted to Edinburgh Royal Infirmary. This new risk assessment tool (freely available from http://www.outcome.org/grace) gives doctors a robust way of identifying high risk patients who need specialist treatment."

Details of the GRACE calculator initiative are published in the online version of the British Medical Journal.